Components and Exacerbating Factors of Compassion Fatigue Experienced by Nurses in a Palliative Care Unit

Abstract

The purpose of this study is to clarify the components and exacerbating factors of compassion fatigue experienced by nurses in a palliative care unit. We performed semi-structured interviews with ten nurses working in a palliative care unit and analyzed the content of the obtained data.

As components of compassion fatigue experienced by nurses in a palliative care unit, six categories were extracted: “recollection of patients’ conditions and rumination on nursing practice outside of working hours”, “depression related to difficulty with empathy”, “a sense of powerlessness due to the inability to provide nursing care focused on quality of life”, “self-blame regarding one’s nursing care”, “resistance to engaging with patients”, and “physical ailments”. Regarding the exacerbating factors of compassion fatigue, seven categories were identified: “continuation of patient suffering caused by differences in direction among healthcare providers”, “difficulties in implementing nursing care that respects the patient”, “difficulty maintaining appropriate psychological distance from patients due to excessive or insufficient empathy”, “feelings of inadequacy related to nursing practice in a palliative care unit”, “an excessively strong sense of mission as a nurse in a palliative care unit”, “lack of knowledge related to palliative care and compassion fatigue”, and “insufficient human support systems”.

It was suggested that understanding the characteristics of compassion fatigue in nurses in a palliative care unit, avoiding leaving the ethical dilemma unaddressed, and talking with colleagues about the events that caused compassion fatigue to view the events objectively are effective to prevent and improve compassion fatigue.